Latest News surrounding Insurance Antitrust Litigation

Nonprofit insurer Blue Shield of California, already under scrutiny for its huge cash reserves and lack of disclosure, is refusing to say how much it’s spending to acquire a Monterey Park insurance company and is seeking confidentiality from state regulators..

The California Department of Managed Health Care said Friday it was still weighing Blue Shield’s request for confidentiality after receiving a public-records request from The Times and being asked to hold a public hearing on the deal by a former company official.

The documents in question pertain to Blue Shield’s proposed acquisition of Care1st, a health plan with more than 500,000 members.

The companies didn’t disclose the terms when the transaction was announced in December. They asked regulators to keep certain details out of public view in filings submitted to the state for review Jan. 30.

Authorities have revoked the tax-exempt status of nonprofit Blue Shield of California, potentially putting it on the hook for tens of millions of dollars in state taxes each year.

The move by the California Franchise Tax Board comes as the state’s third-largest health insurer faces fresh criticism over its rate hikes, executive pay and $4.2 billion in financial reserves.

The state quietly stripped the San Francisco insurer of its exemption from California income taxes in August. The company held that since its founding in 1939.

A spokeswoman for the tax agency declined to comment on the reasons for revocation. The highly unusual action comes after a lengthy state audit that looked at the justification for Blue Shield’s taxpayer subsidy. The insurer has paid federal taxes for years.

Judge David Proctor of the Northern District of Alabama presided over a scheduled Status Conference Hearing in MDL 2406 on Tuesday, March 17, 2015 at 10:00 AM in Birmingham, Alabama.

The putative class action addresses antitrust and unfair business practice claims made by both healthcare Providers and health plan Subscribers against Blue Cross and Blue Shield plans and associated entities across the country.

The Provider plaintiffs are represented by co-lead counsel Edith Kallas and Joe Whatley and Subscriber plaintiffs are represented by co-lead counsel David Boies and Michael Hausfield. Co-lead Counsel Joe Whatley stated ” We feel good with the way the arguments went on in persona jurisdiction and we look forward to the Court’s ruling.”

As the Sunday deadline nears for Bronson Healthcare and Blue Cross Blue Shield of Michigan to work out a contract, it’s not clear if any progress has been made.

In January, the Enquirer reported that Kalamazoo-based Bronson, which operates Bronson Battle Creek hospital among several other facilities in southwestern Michigan, was negotiating a new contract with BCBSM. That contract would continue in-network coverage for inpatient and outpatient services at Bronson hospitals.

BCBSM sent a letter to customers in January saying that coverage of Bronson services could be considered out-of-network by Feb. 15. Only commercial BCBSM and Blue Care Network insurance plans are affected; Medicare supplement plans are not.

Judge David Proctor of the Northern District of Alabama presided over a scheduled Status Conference Hearing in MDL 2406 on Wednesday, January 21, 2015 at 10:00 AM in Birmingham, Alabama.

The Hearing addressed a number of issues to include the status of various Motions to Dismiss, Amended Complaints, on-going discovery issues, jurisdictional questions and administrative matters. Lead counsel for both Plaintiff tracks and Defense addressed scheduled issues and responded to issues presented by the Court. The putative class action brought by both Provider and Subscriber plaintiffs against a number of affiliated healthcare entities has been centralized before Judge David Proctor by the Multidistrict Litigation Panel.

The case addresses health insurance issues and contracts involving both providers and plan subscribers. Magistrate Judge Putnam and Special Master Ed Gentle also participated. Initial Motions to Dismiss have been denied and the case will continue before Judge Proctor.

In an effort to modernize the ancient ethics pledge, officials from the American Medical Association announced Tuesday an update to the Hippocratic Oath that includes a vow of loyalty to national health insurance giant Blue Cross Blue Shield. “This newly revised pledge requires doctors to uphold their allegiance to Blue Cross Blue Shield, to avoid pricey tests and referrals whenever possible, and to do no harm to any in-network patient so far as it remains sufficiently cost-effective,” said AMA spokesperson Amanda Cummings, noting a further addition to the professional oath that obligates doctors to enforce all co-pays and coinsurance payments. “The updated text also requires physicians to have a comprehensive working knowledge of their specific financial agreement with Blue Cross Blue Shield. And above all, a doctor must, at all times, avoid inflicting any injury or wrong upon the company’s bottom line.” Officials added that the new pledge would no longer require doctors to swear by “Apollo the physician, and Aesculapius the surgeon, and likewise Hygeia and Panacea,” but rather by Blue Cross Blue Shield CEO Scott Serota.

Judge David Proctor of the Northern District of Alabama presided over a scheduled Status Conference Hearing in MDL 2406 on Friday, November 07 at 10:00 AM in Birmingham, Alabama.

The Hearing addressed a number of issues to include the status of various Motions to Dismiss, Amended Complaints, on-going discovery issues, jurisdictional questions and administrative matters. Lead counsel for both Plaintiff tracks and Defense addressed scheduled issues and responded to issues presented by the Court. The putative class action brought by both Provider and Subscriber plaintiffs against a number of affiliated healthcare entities has been centralized before Judge David Proctor by the Multidistrict Litigation Panel.

The case addresses health insurance issues and contracts involving both providers and plan subscribers. Magistrate Judge Putnam and Special Master Ed Gentle also participated. Initial Motions to Dismiss have been denied and the case will continue before Judge Proctor.

The Hawaii Medical Service Association boosted compensation for its chief executive Michael Gold by 19 percent to $1.3 million last year as the state’s top insurer prepared to roll out Obamacare.

Gold was one of four isle health insurance executives who received substantial raises as President Barack Obama’s Affordable Care Act overhauled the insurance industry with new benefit requirements and expanded coverage to an estimated 30 million Americans

These types of complaints have already sparked an ongoing investigation by California regulators and other lawsuits seeking class-action status against Anthem and rival Blue Shield of California.

A group of 33 Anthem customers filed suit Tuesday in Los Angeles County Superior Court against the health insurer, which is a unit of WellPoint Inc. Anthem is California’s largest for-profit health insurer and had the biggest enrollment this year in individual policies in the Covered California exchange.

In the latest suit, Anthem members accuse the company of misrepresenting the size of its physician networks and the insurance benefits provided in new plans offered under the Affordable Care Act.